侵袭性曲霉菌感染患者可溶性GM抗原检测分析

Detection of soluble GM antigen in patients with invasive aspergillus infection

目的探讨临床侵袭性曲霉菌感染（IAI）,指导临床防治曲霉菌属感染及医院感染的发生。方法对2012年7月-2014年8月检测2 277例样本,按照曲霉菌半乳甘露聚糖检测试剂盒提供的检测步骤,进行定量检测患者血清中半乳甘露聚糖抗原浓度;将IAI的危险因素、GM试验阳性结果出现的时间作了分析;数据统计采用SPSS17.0统计软件。结果 GM试验阳性167例,阳性率7.3%,其中87例可疑,占3.8%;IAI以呼吸道疾病为首占46.1%,其中肺部感染占31.1%;慢性阻塞性肺疾病占15.0%;集中在ICU、呼吸科、心内科,分别占53.9%、22.7%和6.0%;IAI阳性率51-60岁占17.9%、61-70岁占16.8%、71-80岁居首占26.3%;烟曲霉居首占73.8%。结论 IAI有增多趋势;GM试验具有曲霉菌属感染的早期诊断价值;临床感染烟曲霉菌居多;应密切关注ICU、呼吸科、心内科的老年患者IAI的防治;开展GM检测研究有利于IAI的早期诊断、高危人群的监测、疗效、预后的评价及医院感染的防治。

OBJECTIVE To explore the clinical invasive aspergillus infection so as to provide guidance for clinical prevention and treatment of Aspergillus infection and nosocomial infection .METHODS A total of 2 277 samples were detected from Jul 2012 to Aug 2014 ,then the serum galactomannan （GM ） antigen concentration was quanti‐tatively determined according to the steps of Aspergillus GM detection kit ,the risk factors for the invasive asper‐gillosis infection and the time of the GM being tested positive were analyzed ,and the statistical analysis was per‐formed by using SPSS17 .0 software .RESULTS Totally 167 cases were tested positive for GM with the positive rate of 7 .3% ,and 87 cases were suspected ,accounting for 3 .8% .Among the cases of invasive aspergillus infec‐tion ,the cases of respiratory tract diseases ranked the first place （46 .1% ） ,followed by the cases of pulmonary infections （31 .1% ） and the cases of chronic obstructive pulmonary disease （15 .0% ）;53 .9% of the cases of inva‐sive aspergillus infection distributed in the ICU ,22 .7% in the respiratory department ,6 .0% in the cardiology department .Among the cases of invasive aspergillus infection ,17 .9% were aged between 51 and 60 years old , 16 .8% aged between 61 and 70 years old ,26 .3% aged between 71 and 80 years old .The Aspergillus f umigatus ranked the first place ,accounting for 73 .8% .CONCLUSION The cases of invasive aspergillus infection show an upward trend ;the GM test has the value in early diagnosis of the Aspergillus infection .The A .f umigatus is the predominant species of Aspergillus causing clinical infections .It is necessary to focus on the prevention and treat‐ment of the invasive aspergillus infection in the elderly patients of the ICU ,respiratory medicine ,and cardiology department .The GM test may facilitate the early diagnosis of the invasive aspergillus infection ,monitoring of high‐risk population ,and evaluation of efficacy and prognosis as well as the control of nosocomial infection .